Active NPI
Stefanie Vitucci, APNP
- Psychiatric/Mental Health Nurse Practitioner
- Green Bay, WI
National Provider Identifier
1740030295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 14589-33
- Practice address
- 480 Pilgrim Way Ste 1300-a
Green Bay, WI 54304-5280 - Phone
- (920) 610-5119
- NPI assigned
- Mar 26, 2024
- Last updated
- Apr 23, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 14589 | WI | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 14589-33 | WI | Primary |
Addresses
Primary practice location
480 Pilgrim Way Ste 1300-a
Green Bay, WI 54304-5280
Mailing address
480 Pilgrim Way Ste 1300-a
Green Bay, WI 54304-5280
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14589-33 | WI | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713830400000",
"number": "1740030295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "480 PILGRIM WAY STE 1300-A",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543045280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 PILGRIM WAY STE 1300-A",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543045280",
"telephone_number": "920-610-5119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VITUCCI",
"first_name": "STEFANIE",
"credential": "APNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-26",
"last_updated": "2024-04-23",
"certification_date": "2024-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "14589",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "WI",
"license": "14589-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
- Vision Mart, Inc (Vision Mart)
- Visiting Nurse Association of Wisconsin, Inc (Aurora at Home)
- Visiting Nurse Association of Wisconsin, Inc. (Aurora at Home)
- Visiting Nurse Association of Wisconsin, Inc. (Aurora at Home)
- Visiting Nurse Association of Wisconsin, Inc. (Aurora at Home)
- Vituity-Wisconsin Em SC
- Vituity-Wisconsin Em SC
- Vivent Health Inc
- Vivent Health Inc
- Lisa A Vivian, P.T.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.